This prospective study will examine key unresolved issues concerning the dynamic relationship between posttraumatic alcohol abuse and psychological morbidity. Nine hundred adult survivors of trauma-related physical injuries will be recruited for participation from three large Level I urban trauma centers serving the most populous, and ethnically diverse, county in the United States. Participants will be drawn from three different ethnic groups: Latino-Americans (N = 300), African-Americans (N = 300), and non-Latino Caucasians (N = 300), and will be distributed in approximately equal numbers with respect to gender. The proposed research would leverage a funded NIMH grant, enabling significant substantive and infrastructure synergies. All participants will complete three lay-administered face-to-face assessment interviews, conducted over a 12-month period. The first assessment will take place shortly after hospitalization. The remaining two interviews will be conducted at 3-months and 12-months after the initial interview. The four broad aims of the proposed study of alcohol abuse and psychological morbidity in survivors of significant trauma-related physical injury are: 1) To identify the predictors of alcohol consumption and abuse following traumatic injury. 2) To examine the relationship between alcohol consumption and psychological morbidity following severe trauma exposure. 3) To investigate the relationships among posttraumatic alcohol abuse, health services utilization, and perceived barriers to treatment. 4) To determine whether the antecedents and consequences of alcohol misuse and psychological distress--as well as the pattern of relations between the two constructs-differ as a function of ethnicity and gender.